RCT of a Brief Video Intervention Targeting Peer Inclusion to Reduce Depression-related Stigma in Adolescents

Overview

The goal of this study is to test the efficacy of a brief video intervention emphasizing peer inclusion on depression-related stigma and stigma outcomes (e.g., help seeking attitudes, secrecy) among adolescents 14-18. Timely identification and treatment of depression in adolescents is a public health priority. However, most youth with depression do not seek treatment, and stigma has been identified as the primary barrier to help-seeking. Experiments have found brief video-based interventions (BVIs), 1-2 minute videos similar to those viewed by youth on social media platforms, based on the principle of "social contact" with individuals affected by a stigmatized condition, effective in reducing depression-related stigma and increasing help-seeking among adolescents. However, given the extreme time constraints of these videos, optimizing the messaging is paramount. Prior research has indicated that concerns about peer social inclusion are fundamental in shaping stigma among adolescents. In this 3-arm RCT, we will recruit adolescents aged 14-18 using an online crowdsourcing platform, to test the efficacy of a) standard BVI that addresses mental health treatment but does not address concerns about peer inclusion/exclusion, b) novel BVI focused on mental health treatment and peer inclusion, and c) control condition that provides information without social contact.

Brief video-based interventions (BVIs) have been studied as a means of reducing stigma toward mental health problems and increasing help-seeking among youth. "Contact-based interventions," in which a representative of a stigmatized group shares their personal stories, have been found one of the most effective anti-stigma intervention. Effective contact-based interventions target to a specific population, account for the specific interests of that population, and credibly provide stories that highlight recovery in a plausible manner to moderately disconfirm stereotypes. BVIs package contact-based stigma interventions into a format desirable to youth-- short (1-2 minute) messages in the style of social media content. Prior RCTs have tested BVIs targeting depression-related stigma in adolescents, featuring a young person describing experiences with depressive symptoms, that improved as they sought support from parents and professionals, compared to a control video of a young person discussing family and activities with no mention of mental health. Prior BVIs have not emphasized adolescent concerns about peer rejection and identity. Since existing research emphasizes the central nature of these concerns in shaping mental health-related stigma among adolescents \[4, 5\], BVIs that address peer social concerns may be most effective. Thus, we hypothesize that a BVI focused on peer inclusion will have greater impact on reducing stigma and increasing help-seeking than a BVI with more general content. We will measure three distinct domains of stigma: 1. personally held attitudes, 2. perceptions of how peers may devalue and discriminate against teens with depression, and 3. secrecy (i.e., to avoid potential negative repercussions of stigma).